Lasermed
Lasermed
Summary
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User Manual
English
Revision: 05
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02 .............Presentation 02 .............Equipment Accessories 03 .............General Information 06 .............Symbols 07 .............Warning 08 .............Installation/ Grid Connection 09 .............Display Languages 10 .............Functions of controls 12 .............Laser Probes 16 .............Modes of operation 16 .............Device Operation 18 .............Mode: Energy Therapy 19 .............Mode: Nogier Therapy 21 .............Mode: Free Therapy 22 .............Protocols 26 .............Operation of the toposcopic pen 27 .............Types of applications 27 .............Master Control Key and Remote Interlock Connector 28 .............Indications 31 .............Contraindications 31 .............Preventive maintenance and preservation 33 .............Safety Warning 34 .............Corrective maintenance 35 .............Technical features 37 .............Declarations 43 .............Final considerations 42 ………..European Representative 42 .............Bibliographical references
Lasermed
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Lasermed
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Presentation
General Information
Carci is proud to congratulate you for the aquisition of a high technology and security equipment. Where we are sure this equipment will satisfy the highest quality standards.
The term LASER means Light Amplification by Stimulated Emission of Radiation. This light radiation has unique characteristics, different from ordinary light, such as:
LASERMED – 4098 was designed according to IEC 60601-1:1994 + amend 1:1997, IEC 60601-2-2006, and IEC 60601-2-22:1997 safety rules, which makes them a safe and reliable product.
o
Coherence :
o
Polarization: laser
o
Monochromaticity:
Equipment Accessories • • • • •
01 01 01 01 01
Laser Probe 905nm, 20mw (60Watts peak) - pulsed Laser probe cable Tripolar power cable Toposcopic pen User Manual
The Lasermed 4098 can be supplied with Laser probe in the lenght of 905nm (infrared) pulsed with 60W of of peak, 830nm (infrared) continuous with 30mW continuous and 650nm (red) continuous with 12mW continuos. To buy optional accessories, please verify the codes at page 36, ‘Additional Accessories ’. If you have any doubt, please contact: Technical Assistance Department Rua Álvares Fagundes, 359 São Paulo – SP – Brasil Brasil -CEP 04338-000 Tel.: (0XX11) 5621 7024 / 5622 8205 e-mail :
[email protected]
while ordinary light is made up of several wavelengths and spatially arranged in disorderly fashion, laser emission is formed by one wavelength only, bearing waves coherent between itself, both time wise and spatial wise; radiation is polarized, which allows its parallelism, which does not occur in ordinary light; due to the existence of only one wavelength, laser radiation becomes monochromatic.
Since laser radiation is made up of photons that transport energy, on applying laser radiation on any surface, we are transferring Energy. On applying laser radiation on a tissue, we are transferring a certain amount of energy. With this energy’s application, we obtain effects we can describe as direct (or primary), indirect and therapeutic.
Lasermed
below:
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The effects of radiation on tissues are represented by the scheme
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Figure 1 shows laser radiation absorption by hemoglobin and water:
Radiation Absorbed
Direct Effects or Biochemical Effect Primary: Bioelectric Effect Bioenergetic Effect
Indirect Effects:
Microcirculation stimulation Cellular trophic stimulation
Therapeutic Effects:
Analgesic Anti-inflammatory Anti-edematous Stimulates tissue trophism
Laser has been used successfully and efficiently in physiotherapy in the treatment of painful, inflammatory processes, ulcers, joint disorders, fracture repair and especially in traumatic lesions in sports practice. Usually, laser therapy uses emitters with wavelengths between 600 nm and 1100 nm (nanometers), since wavelengths of less than 600 nm and greater than 1100 nm are strongly absorbed by the skin, consequently reducing penetration depth.
wavelength
figure 1
Hemoglobin absorbs wavelengths of less than 600 nm, where the Argon lasers (514 nm, green) are located, and water absorbs wavelengths of more than 1200 nm, where the CO2 and NdYg lasers are located. Due to these particularities, Argon, CO2 and NdYg lasers are used for surgical incisions. Through several scientific studies, one notes that variables in this radiation’s wavelength, as well as in its power of emission, are responsible for the success obtained in therapeutic pursuits. With this in mind, CARCI developed a state-of-the-art laser emission equipment, with wavelength and power variables for precise and adequate treatment, according to the type of tissue involved, depth and pathological phase.
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Lasermed
Symbols Equipment symbols
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Symbols on the pack
Equipment off
Caution fragile. Handle with care
Equipment on Keep in a dry place
This equipment has physiological effects. Consult instructions manual.
This side up. This symbol indicates the right transport position
Applied part is type BF Maximum piling. Indicates the maximum number of boxes that can be piled. The quantity is marked in the intermediary square.
Manufacturing date
Minimum and maximum temperature limits for transport and storage.
Serial number
IPX0
Not protected from harmful water penetration Manufacturer identification This symbol indicates Hazard Laser radiation
Warning 1. 2. 3.
Class II Equipment
CE Mark and certifying body identification European representative
This equipment should only be used by a qualified person The operation in short distance (example: 1meter) from a shortwave diathermy or a Microwave equipment can produce instability on Lasermed operation. Do not put the equipment in soft basis that can close the inferior ventilation holes.
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Installation/ Grid Connection The equipment must be positioned for use such that there is no obstruction of the cabinet’s lower openings. For perfect operation of your equipment, we suggest that the electrical installations comply with the following standards:
•
•
Your equipment uses switched power supply and operates at any voltage between 100 and 240V ~ 50 or 60Hz; If the protective fuse burns, change it, as shown in in the figure above, for the value:
Brazil:
NBR 5410/1990 – Low-voltage electrical installations; NBR13534/1995 – Electrical installations in health establishments – Safety requisites.
• •
Other • •
The fuses should be: 1.0A 250V (20AG)
countries: IEC 60364-7-710/2002 – Electrical installations – medical locations; Or another listed standard applied in the country of use.
Display language LASERMED allows three display languages to be accessed: Portuguese English
The electric power supply’s voltage must be within the range specified in the Technical Features, otherwise, there can be reduced equipment performance and safety risk. •
Connect the power power cable to the 3-pole connector located in the back panel and connect it to the electric power socket;
Spanish
In case you wish to change the current language, follow the steps below: 1.
Connect the LASERMED’s power cable to the electric network.
2.
Switch on the device – the equipment will test the display and processor circuit, The display will give the following information:
SN.: 00001
3. Figure 02
Next, press and hold the key
LASERMED 4098 Rev.: 4.3
Lasermed 4.
After the equipment emits a beep, release the Keys .
5.
The display will show the accessible languages: ENGLISH
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Lasermed
Moves to the next field
PORTUGUESE
SPANISH
Decreases 6.
Increases
Select the desired language through the keys
Set
7.
Press the key
8.
The equipment will exit the language selection mode, showing the Main menu.
Functions of Controls Laserrmed Panel
Moves to the former field
Infrared laser emission sensor.
Menu screen’s selection key
Key to enable the selected parameter.
Key to enable and disable the Lasermed probe.
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Lasermed
Laser
Probes
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CONECTION LASER CABLE + LASER PROBE
Figure 05 Laser aperture
Figure 03
LASERMED PROBE LABELS. Lasermed Probe Infrared 830 nm Continuous (Blue Body)
LASER PROBE CABLE
Figure 04
Lasermed Probe Infrared 905 nm Pulsed (Blue Body)
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Lasermed
Toposcopic
Probe
Lasermed Probe Infrared 650 nm Continuous (White Body)
1. 2. 3.
The laser probe label bears the following information: Laser source class Wavelength Laser type (infrared or red) Peak power/ Mean power Serial number Manufacturing date Invisible laser radiation hazard OBS.: Lasermed automatically detect which Laser probe is being used at the moment. • • • • • •
•
Lasermed and toposcopic probe indication label
Toposcopic probe connector to the Lasermed Active electrode Neutral electrode (dispersive)
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Modes of operation LASERMED 4098 has two modes of operation:
Lasermed
The display will give the following information:
Therapy Toposcopic SN.: 00001
1. Therapy – Energy Just set the value of the energy desired from 50 mJoules (0.05J) to 10.000 mJoules (10J). The application time is calculated automatically by the processor.
Right after, the equipment enters the OPERATION MODE:
2. Therapy – Nogier Select the Nogier frequency desired or the frequencies of 16Hz and 48Hz (calcium cycle), and the application time of the frequency selected. 3. Therapy – Free Set the application time from 1 to 999 seconds;
•
Use the keys to change to the Toposcope screen
•
THERAPY
905 nm
ENERGY NOGIER FREE PROTOCOLS
TOPOSCOPY
905 nm
Sensitivity Low High XXXXXXXXXXXXXXXXXXXX
Used to locate acupuncture points, or Trigger Points. MODE LASER
Device operation
•
MODE LASER
MODE LASER
Toposcopic Mode
•
LASERMED 4098 Rev.: 4.3
In the Therapy mode, select select the form of application:
•
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Connect the power cable in the device to the power network; Connect the laser cable to the laser pen and to the device (Figure 05 page 14); Position the Master Control Key to Press the ON / OFF switch at the back of the device device (Figure 02 page 10);
Or to use the Therapy mode.
ENERGY NOGIER FREE PROTOCOLS
THERAPY
905 nm
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1. Mode: ENERGY THERAPY Press the key to enable the mode: Therapy
Press the key to enable the mode: Power
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To start the therapy, position the probe on the application site, and press the MODE LASER
THERAPY 905 nm
probe's
ENERGY ENERG Y
NOGIER FREE PROTOCOLS
MODE LASER Set to Save ENERGY TIME SENSOR LASER
Use the keys for the Energy desired.
Lasermed
MODE LASER Set to Save ENERGY TIME SENSOR LASER
key.
To interrupt the application, press the Press again to restart ENERGY 905 nm J S
00.00
00.00 000.0 000.0 Total XXXXXXXXXX OFF
ENERGY 905 nm J S
Press the
key.
key to return to the main screen
2. Mode: NOGIER THERAPY
MODE LASER
In the main screen, press the
ENERGY NOGIER FREE PROTOCOLS
key to enable the therapy mode.
00.00 000.0 Total XXXXXXXXXX OFF
THERAPY
905 nm
00.10
000.5
The application time for the Energy desired is automatically adjusted by the microcontroller.
MODE LASER
Use the Nogier mode.
keys to select the
Note : Just the probe 905nm is able for Nogier function.
To enable the laser pen, press the key of the panel. The indication in the panel : LASER OFF , , will change to : LASER Stand By and the pen's Green LED will remain on, showing that the probe is ready for application. Press the Nogier mode.
key
THERAPY 905 nm
ENERGY NOGIER NOGIE R
FREE PROTOCOLS
MODE LASER Set to Save FREQUENCY TIME S SENSOR LASER
NOGIER 905 nm 2.5 Hz 000.0
000.0 Total XXXXXXXXXX OFF
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Use the keys to select the desired time.
MODE LASER Set to Save FREQUENCY TIME SENSOR LASER
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NOGIER 905 nm 2.5 Hz S
001.0
000.0 Total XXXXXXXXXX OFF
Lasermed
The indication in the panel : LASER OFF will change to : LASER Stand By and the probe's Green LED will remain on, showing that the probe is ready for application. To start the therapy, position the probe on the application site, and press the probe's
key.
To interrupt the application, press the Press again to restart.
Use the keys to enable the FREQUENCY Function
MODE LASER Set to Save FREQUENCY TIME SENSOR LASER
Use the keys to select the desired frequency.
MODE LASER Set to Save FREQUENCY TIME SENSOR LASER
NOGIER 905 nm 2.5 Hz 000.0 000.0 Total XXXXXXXXXX OFF
S
NOGIER 905 nm
Press the
key.
key to return to the main screen
3. Mode: FREE THERAPY In the main screen, press the mode.
key to enable the therapy
48 Hz 010.0 000.0 Total XXXXXXXXXX OFF
MODE LASER
THERAPY
905 nm
ENERGY NOGIER FREE PROTOCOLS
S
Nogier Frequencies: 2.5 Hz; 5 Hz; 10 Hz; Hz; 20 Hz; 40 Hz; 73 Hz; 80 80 Hz; 146 Hz; 160 Hz; 262 Hz; 292 Hz; 584 Hz; Calcium cycle activation frequencies: 16 Hz and 48 Hz. These Frequencies are enabled for the 905 nm pen only.
To enable the laser probe, press the
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key of the panel.
MODE LASER
Use the keys to select the Free mode.
ENERGY NOGIER FREE
PROTOCOLS
THERAPY 905 nm
Lasermed
Press the key to enable the FREE mode of operation Use the the desired TIME.
keys to select
MODE LASER Set to Save TIME SENSOR LASER
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Lasermed
FREE 905 nm
S
010.0
000.0 Total XXXXXXXXXX OFF
MODE LASER
Use the keys to select PROTOCOLS.
ENERGY NOGIER FREE
key
Use the keys to select the desired PROTOCOL. 4.1. RETURN
screen .
Go back to the main
Press the
key to Return.
SAVE USER’S FIX
key. 4.2.SAVE Record the protocol in the
memory. To stop or reestart the aplication, press the key
of the probe.
To desability the use of the laser probe, press the key
4. PROTOCOLS
The display will give the following screen :
In the main screen, press the key to enable the therapy
MODE LASER ENERGY NOGIER FREE PROTOCOLS
PROTOCOLS RETURN SAVE
Press the record mode.
mode.
PROTOCOLS RETURN RETUR N
To start the therapy, position the probe on the application site, and press the probe's
THERAPY 905 nm
PROTOCOLS PROTO COLS
Press the
To enable the laser pen, press the key of the panel. The indication in the panel : LASER OFF will change to : LASER Stand By and the probe's Green LED will remain on, showing that the probe is ready for application.
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key to select the
USER’S FIX
THERAPY
905 nm
Use the and select the letter desired. Press the
keys to
key to write or the
key to erase.
1 2 3 4 5 a b c d e k l mn o u v wx y Stp to DEL
6 f p z
11--------------
7 g q ç
8 h r ,
9 0 i j s t .
Lasermed
PROTOCOLS
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Lasermed
STP TO DEL
XXXXX XXXX X
YYYYY ZZZZZ
To save the protocols, press the key The display will give the following Protocols recorded
4.3. USER’S
Press the key to enable the Selected mode User’s. Use the
keys to select the Protocol desired, and Press the key to enable the selected Protocol.
For erase the Protocol, select the Protocol desired and press the Key. The display will give the following screen : PROTOCOLS
STP TO DEL
XXXXX XXXX X
For erase press the
key, or the
to keep.
YYYYY ZZZZZ
DELETE ? SET = YES MENU = NO
To return to main screen, you must to select a Protocol and press key 4.4. FIX The display will give the
following Lasermed Protocols.
Use the
keys to select the Protocol
desired, and Press the enable the selected Protocol. Press the
key to
key to enable the probe.
PROTOCOLS ATM
TORTICOLLIS ARTHROSIS ARTHRITIS TENDONITIS PERIARTHRITIS
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Types of Application
5. TOPOSCOPY.
The application may be point or scan.
TOPOSCOPIC PEN OPERATION In the main screen, use the keys to select the screen: TOPOSCOPY
PEN MODE
THERAPY 905 nm
POINT: Used when one wishes to deposit a determined energy at a point, or to stimulate the acupuncture points, placing the laser probe perpendicular to the skin. The modes of operation used are: Continuous – Energy and Nogier.
ENERGY NOGIER FREE PROTOCOLS
Press the
key
PEN MODE
TOPOSCOPY 905 nm
Sensitivity Low
High
SCAN: Used when one wishes to apply a determined energy on a previously determined area. The laser radiation is applied by scanning the entire area to be treated. The mode of operation used is Continuous - Free
NOTE:
When asepsis of the location is required, do not touch the probe on the skin, leaving it at a maximum distance of 1 cm.
Connect plug 1 (picture C, page 16) of the toposcopic probe to the TOPOSCOPE PROBE connector of the device. The patient must hold the negative electrode (3) of the toposcopic probe firmly; PEN MODE
Use the keys to increase the sensitivity to the maximum.
TOPOSCOPY 905 nm
Sensitivity Low High XXXXXXXXXXXXXXXXXXXX
With the active electrode (2) of the toposcopic probe touching the patient’s skin, loop for the region of acupuncture points / trigger points. A sound signal will be emitted. Reduce the sensitivity gradually, and look for the acupuncture point in the region selected; the sound signal emitted must be continuous and clear.
Master Control Key and Remote Interlock Connector Lasermed 4098 has two safety keys called Master Control Key and Remote Interlock Connector to prevent use of the device by unqualified personnel.
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The Master Control Key locks the equipment, equipment, preventing enabling of the laser probe. When the key is in unlocked.
, the device is locked, and in
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DOSIMETRY : Point application
the device is
When the key of the device is in (locked), and the key is pressed, a sound signal (beep) will be emitted and the information LOCKED will be displayed. MODE PROBE ENERGY TIME
ENERGY 905 nm mJ S
01.50
001.5
00.00 000.0
LOCKED LOCKE D
Total SENSOR
XXXXXXXXXX
The Master Control Key is removable for user/owner safety. The Remove Interlock Connector is an environmental protection device (accessory). The key is connected to the Lasermed and the room’s entrance door. If the door is opened, Lasermed suspends the operation, the display will display the information LOCKED and the t he sound signal (BEEP) will be emitted.
Indications
-
Traumatic lesions Dermatology : ulcers / wounds Esthetics : repairing surgeries Ligament lesions Cartilage lesions Bed sores
•
GENERAL INDICATIONS
NOTE : The laser probes energy ,mentioned on table above, are for point application .
•
-
Inflammatory processes Acupuncture Muscular lesions Tendinous lesions Bone lesions
• •
INDICATIONS REGARDING THE EFFECT (Point Application) Analgesic Effect: muscular pain - joint pain Anti-Inflammatory Effect Regenerative Effect Circulatory Effect
: : : : :
2 to 4 4 to 8 1 to 3 3 to 6 1 to 3
Joules/cm2 Joules/cm2 Joules/cm2 Joules/cm2 Joules/cm2
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WAVELENGTH INDICATIONS
Pen 650 nm: skin lesions Pen 830 nm: superficial lesions lesions – up to 2 cm depth Pen 905 905 nm: deep lesions – more than 2 cm depth 2
1 to 3 Joules/cm 4 to 6 Joules/cm2 6 to 10 Joules/cm2
• • •
Lasermed
-
acute lesions sub-acute lesions chronic lesions
DOSIMETRY SUGGESTIONS:
ATM :
Torticollis:
Arthrosis:
Arthritis:
Tendonitis:
Periarthritis:
Bursitis:
Sciatic pain:
Effort hernia:
Contusions:
Hematomas:
Epicondylitis:
- -
-
-
3 to 4 Joules/cm2 Daily 4 to 5 Joules/cm2 Daily 4 to 6 Joules/cm2 Alternate 6 to 8 Joules/cm2 Daily 4 to 8 Joules/cm2 Daily 4 to 8 Joules/cm2 Daily / alternate 4 to 7 Joules/cm2 Daily 4 to 8 Joules/cm2 Daily 4 to 6 Joules/cm2 Daily 2 to 4 Joules/cm2 Daily 4 to 6 Joules/cm2 Alternate 4 to 6 Joules/cm2 Daily
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MODULATION FREQUENCY INDICATIONS:
Calcium cycle activation 16 Hz and 48 Hz
Immune system modulation 73 Hz, 146 Hz, 292 Hz
Chronic pain 2.5 Hz, 5 Hz, 20 Hz
Acute pain 80 Hz, 160 Hz, 262 Hz
Acupuncture Points 2.5 Hz, 5 Hz, 10 Hz, 20 Hz, 40Hz, 80 Hz
Contraindications ABSOLUTE CONTRAINDICATIONS
Retina Neoplasias Abdominal region of pregnant women Metastases
• • •
•
RELATIVE CONTRAINDICATIONS
Near gonads and breast nodules Hypo or hyperactive glands Corticoid intake Treatment with photosensitive drugs
• • • •
Preventive and preservative maintenance •
Avoid leaving the laser probe on Stand By for more than 5 minutes;
We recommend inspecting and calibrating the LASERMED 4098 once a year by CARCI; •
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EUROPEAN REPRESENTATIVE
EUROPEAN REPRESENTATIVE
OBELIS S.A. 34, Av. de Tervuren, bte 44 B-1040 Brussels, BELGIUM Tel: (32) 2.732.59.54 Fax: (32) 2.732.60.03 E-mail:
[email protected]
Bibliographical references
1- La Terapia Laser , Hoy Josep Colls – Edita Centro de Documentacion Laser – Barcelona – 3 edicion - 1986 2- Physical Agents in Rehabilitation – From Research to Practice Michelle H. Cameron - W.B. Saujnders Company – Philadelphia – 1 Edition - 1999 3- Therapeutic Lasers - Theory and Practice G. David Baxter – Churchill Livingstone - 1994 4- Tratamientos con Laser – Metodo Diagnostrat Carlos Lasvi – Minaguano Ediciones – Madrid - 1986 5- Laser y Terapeutica em Medicina 6- J.L. Cisneiros – M.A Trelles – Centro Documentation Laser – Barcelona – 1 Edicion - 1987 7- Low Reactive Level Laserf Therapy – Practical Practical Application Application T. Oshiro – John Wiley & Sons Ltd – 1 Edition – 1991
